Lung flukes (paragonimiasis)
Update:
Epidemiology—Paragonimus kellicotti emerging pathogen in the United States of America.
Investigation—Ziehl–Neelsen staining superior to wet smear for detecting ova in sputum.
Paragonimiasis is an infection by flukes of the genus Paragonimus, with foci of disease in Asia, Africa, and Central and South America. Humans acquire infection by eating metacercariae in improperly cooked freshwater crabs or crayfish. Acute inflammatory and allergic symptoms are rarely serious and usually resolve spontaneously. Chronic manifestations may be (1) pulmonary—most remarkably with a chronic, productive cough with jam-like, brownish-red sputum; and (2) extrapulmonary—most importantly in the central nervous system, often presenting with seizures. Diagnosis is by demonstrating ova in sputum, stool, or pleural fluid. Serology can be used to support the diagnosis, especially in extrapulmonary paragonimiasis. Treatment with praziquantel is almost always effective. Prevention is by health education and the mass treatment of infected people in an endemic area.
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